Bayesian statistical methods and Medicare evidence MEDCAC

CMS evidence review | evidence_type=MEDCAC Meeting | record_type=medcac_meeting | document_id=49 | meeting_date=2009-06-17

This meeting will focus on the use of Bayesian statistics to interpret evidence in making coverage decisions. The meeting will introduce Bayesian concepts, contrast Bayesian approaches with frequentist approaches, and provide some examples of using Bayesian techniques for meta-analyses.

Actions Taken: May 12, 2009 Posted Federal Register notice announcing meeting. May 20, 2009 Posted questions to panel. June 05, 2009 Posted technology assessment . June 16, 2009 Posted roster , agenda and speaker list for meeting. June 18, 2009 Posted scoresheet [PDF, 447KB] from meeting. August 14, 2009 Posted minutes [PDF, 1.42MB] and transcript [PDF, 472KB] from meeting. Agenda: Federal Register Notice Agenda Medicare Evidence Development & Coverage Advisory Committee June 17, 2009 7:30 AM - 4:30 PM CMS Auditorium Cliff Goodman, PhD, Chair Saty Satya-Murti,Vice Chair Marcel Salive, MD, Coverage and Analysis Group Maria Ellis, Executive Secretary 7:30 - 8:00 AM Registration 8:00 - 8:15 AM Opening Remarks and questions Maria Ellis/Marcel Salive, MD, MPH/Cliff Goodman, PhD 8:15 - 9:15 AM Steven Goodman, MD, PhD, Professor, Director, Oncology Biostatistics, Johns Hopkins Bloomberg School of Public Health, "Bayesian Concepts I: Measuring the Strength of Evidence" 9:15 - 10:15 AM Donald Berry, PhD, Professor, Chairman, Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, "Bayesian Concepts II: Use and Interpretation of Bayesian Methods in Design and Analysis of Clinical Trials" 10:15- 10:30AM BREAK 10:30 - 11:15 AM Roger Lewis, MD, PhD, Department of Emergency Medicine, David Geffen School of Medicine at UCLA, "Application of Bayesian Concepts in Clinical Decision Making" 11:15 - 12:00 PM Sharon-Lise Normand, PhD, Professor, Health Care Policy (Biostatistics), Harvard Medical School, "Application of Bayesian Concepts in Policy Decision Making" 12:00 - 1:00 PM LUNCH 1:00 - 1:45 PM Gillian Sanders, PhD, Associate Professor of Medicine, Duke University and Donald Berry, PhD, Professor, Chairman, Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, "Meta Analyses of ICDs" Public attendees, who have contacted the executive secretary prior to the meeting, will address the panel and present information relevant to the agenda. Speakers are asked to state whether or not they have any financial involvement with manufacturers of any products being discussed or with their competitors and who funded their travel to this meeting. 1:45 - 2:00 PM Scheduled Public Comments (Refer to Speaker List) 2:00 - 2:10 PM Open Public Comments - (Public Attendees who wish to address the panel will be given the opportunity.) 2:10 - 2:40 PM Questions to Presenters 2:40 - 3:40 PM Open Panel Discussion: Dr. Goodman 3:40 - 4:15 PM Formal Remarks and Voting - (The Chairperson will ask each panel member to state his or her position on the voting questions) 4:15 - 4:30 PM Closing Remarks/Adjournment: Dr. Salive & Dr. Goodman Issue: This meeting will focus on the use of Bayesian statistics to interpret evidence in making coverage decisions. The meeting will introduce Bayesian concepts, contrast Bayesian approaches with frequentist approaches, and provide some examples of using Bayesian techniques for meta-analyses. Minutes: Download meeting minutes . [PDF, 1.42KB] Other Material: Transcript 1 Panel Voting Questions: Questions In assessing the strength of evidence for the effectiveness of a medical intervention that incorporates Bayesian design or analysis, compared to a frequentist approach, please discuss the following: What are the greatest potential strengths of a Bayesian approach? What are the greatest potential weaknesses of a Bayesian approach? For discussion How confident are you that potential strengths of Bayesian approaches outweigh the potential liabilities in the design and interpretation of a published study? In designing studies In interpreting study results 1……...................... 2……………...…….. 3………………..….. 4……..………..…….. 5 Liabilities outweigh No difference Strengths outweigh Strengths Liabilities For discussion How confident are you that CMS should incorporate evidence that uses Bayesian approaches in trials or technology assessments submitted for coverage decisions? Clinical trials Technology assessments 1……...................... 2……………...…….. 3………………..….. 4……..………..…….. 5 CMS should No position CMS should Discourage Encourage Download scoresheet [PDF, 447KB] Roster: June 17, 2009 MEDCAC Roster Clifford Goodman, PhD Chair Senior Vice President The Lewin Group Saty Satya-Murti, MD, FANN Acting Chair Health Policy Consultant David A. Axelrod, MD, MBA Surgical Director of Kidney & Pancreas Transplantation Dartmouth-Hitchcock Medical Center John Cox, DO, FACP Texas Oncology, PA Methodist Charlton Cancer Center Mercedes K.C. Dullum, MD Section of Cardiothoracic Surgery Cleveland Clinic in Florida Sharon-Lise Normand Professor Health Care Policy (Biostatistics) Harvard Medical School Mark D. Grant, MD, MPH Associate Director Technology Evaluation Center BlueCross BlueShield Association Gillian Sanders, PhD Associate Professor of Medicine Duke University Mark A. Hlatky, MD Professor, Health Research and Policy and Cardiovascular Medicine Stanford University School of Medicine William H. Maisel, MD, MPH Cardiovascular Division Beth Israel Deaconess Medical Center Harvard Medical School Curtis A. Mock, MD, MBA Senior Regional Medical Director Consumer Decision Support and Advocacy United Healtcare Joshua P. Prager, MD, MS Director, California Pain Medicine Center Director, Center for Rehabilitation of Pain Syndrome (CRPS) Industry Representative Jose Alvir, Dr.PH Director, Statistics, Outcomes Research Clinical Research and Development Pfizer, Inc. Guest Speakers Donald Berry, PhD Professor Chairman Department of Biostatistics The University of Texas M.D. Anderson Cancer Center Steven Goodman, PhD Professor Director Oncology Biostatistics Johns Hopkins Bloomberg School of Public Health Roger Lewis, MD, PhD Department of Emergency Medicine David Geffen School of Medicine at UCLA CMS Liasion Marcel Salive, MD Director Division of Medical & Surgical Services Coverage and Anaylsis Group Executive Secretary Maria A. Ellis Speaker List: Medicare Evidence Development & Coverage Advisory Committee June 17, 2009 SPEAKER LIST * 7 MINUTES PER SPEAKER* Bryan R. Luce, PhD, MBA, Senior Vice President, Science Policy, United BioSource Corporation